Intraoperative Retrobulbar Hemorrhage following Subtenon Anaesthesia and Valsalva Manoeuver: A Case Report: General Ophthalmology

O Olawoye Olusola; O Idam Patrick; A Ibukun Folahan

Authors

O Olawoye Olusola Department of Ophthalmology, College of Medicine, University of Ibadan, Nigeria
O Idam Patrick Deparment of Ophthalmology, University College Hospital, Ibadan, Nigeria
A Ibukun Folahan Deparment of Ophthalmology, University College Hospital, Ibadan, Nigeria

Abstract

Introduction: An advantage of sub-tenon’s over retrobulbar injection is the lower risk of retrobulbar hemorrhage (RBH) associated with the former. We present a case of RBH noticed intraoperatively during trabeculectomy surgery following subtenon anaesthesia and Valsalva manoeuvre.

Case Report: A 51 year old woman presented with poor vision OS first noticed two years prior to presentation. She was not a known hypertensive and had no prior history of bleeding disorders. Examination at presentation showed a visual acuity of 6/6-2 OD and HM OS, RAPD OS, open angles on gonioscopy OU, CDR 0.5 OD and 1.0 OS. Based on a diagnosis of Open-angle glaucoma and suboptimal IOP control on medications, she was scheduled bilateral trabeculectomy. Preoperatively she had O’Brien facial block and then sub- tenon’s injection just prior to commencement of right trabeculectomy.

Author Biography

O Olawoye Olusola, Department of Ophthalmology, College of Medicine, University of Ibadan, Nigeria

Deparment of Ophthalmology, University College
Hospital, Ibadan, Nigeria

References

Retrobulbar hemorrhage - EyeWiki [Internet]. [cited 2017 Oct 2]. Available from: http://eyewiki.org/Retrobulbar _hemorrhage

Sullivan TJ, Wright JE. Non-traumatic orbital haemorrhage. Clin. Experiment. Ophthalmol.28(1), 2000; 26–31.

Rahman I, Ataullah S. Retrobulbar hemorrhage after sub-Tenon’s anesthesia. J. Cataract Refract. Surg. 2004; 30(12): 2636–2637.

Olitsky SE, Juneja RG. Orbital hemorrhage after the administration of sub-Tenon’s infusion anesthesia. Ophthalmic Surg. Lasers28(2), 1997; 145–146 .

Winterton J V., Patel K, Mizen KD. Review of Management Options for a Retrobulbar Hemorrhage. J Oral Maxillofac Surg [Internet]. 2007 Feb 1 [cited 2017 Oct 2];65(2):296–9. Available from: http:// www.sciencedirect.com/science/article/ pii/S027823910601192X

Craig D. Lewis; Julian D. Perry. Retrobulbar Hemorrhage [Internet]. Expert Rev Ophthalmol. 2007 [cited 2017 Oct 2]. p. 2(04):557-570. Available from: h t t p : / / w w w . m e d s c a p e . c o m / viewarticle/562682